CONTEXT: Although intimate partner violence and anal intercourse are common in young adult relationships, few
studies have examined whether these behaviors are associated with each other.

METHODS: Data from 6,280 women aged 18–28 who took part in Wave 3 of the National Longitudinal Study of
Adolescent Health were used to examine the association between physical and sexual intimate partner violence and
anal intercourse in 10,462 relationships. Multivariate hierarchical random eff ects models were used to adjust for the
clustered survey design and for the multiple relationships reported per participant.

RESULTS: Physical violence occurred in 29% of relationships, sexual violence in 11% and anal intercourse in 14%.
The odds that a couple had had anal intercourse were greater among relationships that included physical violence
perpetrated by both partners or only by the woman than among nonviolent relationships (odds ratios, 1.7 and 1.9,
respectively). The odds of anal intercourse were also elevated among sexually abusive relationships, although only if
the woman was the sole victim or the sole perpetrator (1.3 and 2.0, respectively). In relationships that included anal
intercourse, the odds of condom use were lower if the woman was a victim of physical violence than if no violence
occurred (0.2). Sexual violence was not associated with condom use.

CONCLUSION: Women in physically violent relationships may be at increased risk for STDs because of their elevated
exposure to unprotected anal intercourse. More information on the context surrounding anal intercourse and
intimate partner violence is needed to understand the nuances of this association.

AUTHOR AFFILIATIONS

At the time this
study was conducted,
Kristen L. Hess was
a doctoral student
at the Fielding
School of Public
Health, University
of California, Los
Angeles. Marjan
Javanbakht is
associate professor
in-residence, Department
of Epidemiology;
Joelle M. Brown
and Paul Hsu ar e
adjunct assistant
professors, Department
of Epidemiology;
Pamina M. Gorbach
is professor, Department
of Epidemiology;
and Robert E. Weiss is
professor, Department
of Biostatistics—all at
the Fielding School of
Public Health.